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Sun, Qingzhou, Peng Wang, Hongyu Liu, and Yongfang Liu. "Discrepancies in Risk Preference in Other-regarding Decision Making." Social Behavior and Personality: an international journal 45, no. 2 (March 6, 2017): 235–41. http://dx.doi.org/10.2224/sbp.5726.
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We explored the discrepancies in risk preference in other-regarding decision making from the perspective of construal level theory. We recruited 166 university undergraduates to participant in a 2 (other: close or distant) × 2 (role of the decision maker: deciding for others vs. predicting the decisions of others) × 2 (domain: gain or loss) experiment. Results showed that participants were more risk seeking in distant other-regarding decisions than in close other-regarding decisions, when predicting the decisions of others than when deciding for others, and in the loss domain than in the gain domain. Such effects were stronger in the gain domain than in the loss domain. These findings suggest that people's risk preferences in other-regarding decision making are changeable, depending on whom they decide for and which role they play.
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Dal Monte, Olga, Cheng C. J. Chu, Nicholas A. Fagan, and Steve W. C. Chang. "Specialized medial prefrontal–amygdala coordination in other-regarding decision preference." Nature Neuroscience 23, no. 4 (February 24, 2020): 565–74. http://dx.doi.org/10.1038/s41593-020-0593-y.
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Orlova, Olena. "Levels of other-regarding preferences and the structure of the interaction." Decyzje, no. 27 (December 15, 2017): 5–38. http://dx.doi.org/10.7206/dec.1733-0092.93.
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The paper contributes to the literature on other-regarding preferences challenging the narrow self-interest assumption. Experimental evidence confirms that the same individuals might express different otherregarding preferences in different situations or contexts. The structure of their interaction, their relative positions in it might trigger different behavioral patterns. In this paper we propose a model of multi-level other-regarding preferences assuming that different levels are actualized depending on the context in which an individual has to take her decision. We analyze the experimental trust game letting the players have multi-level preferences. Under certain parameterization and asymmetric information assumption, we show that the share given up by the leader of the game in favor of the follower is strictly monotonically increasing with altruism of the former. It is also demonstrated that utilitarian social welfare is increasing with the leader’s altruism if the players are not extremely risk-averse. In the case when information for both players is incomplete, a separating equilibrium exists allowing to distinguish between leaders with different other-regarding preferences.
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Ghaffari, Minou, and Susann Fiedler. "The Power of Attention: Using Eye Gaze to Predict Other-Regarding and Moral Choices." Psychological Science 29, no. 11 (October 8, 2018): 1878–89. http://dx.doi.org/10.1177/0956797618799301.
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According to research studying the processes underlying decisions, a two-channel mechanism connects attention and choices: top-down and bottom-up processes. To identify the magnitude of each channel, we exogenously varied information intake by systematically interrupting participants’ decision processes in Study 1 ( N = 116). Results showed that participants were more likely to choose a predetermined target option. Because selection effects limited the interpretation of the results, we used a sequential-presentation paradigm in Study 2 (preregistered, N = 100). To partial out bottom-up effects of attention on choices, in particular, we presented alternatives by mirroring the gaze patterns of autonomous decision makers. Results revealed that final fixations successfully predicted choices when experimentally manipulated (bottom up). Specifically, up to 11.32% of the link between attention and choices is driven by exogenously guided attention (1.19% change in choices overall), while the remaining variance is explained by top-down preference formation.
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Colman, Andrew M. "Love is not enough: Other-regarding preferences cannot explain payoff dominance in game theory." Behavioral and Brain Sciences 30, no. 1 (February 2007): 22–23. http://dx.doi.org/10.1017/s0140525x07000659.
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Even if game theory is broadened to encompass other-regarding preferences, it cannot adequately model all aspects of interactive decision making. Payoff dominance is an example of a phenomenon that can be adequately modeled only by departing radically from standard assumptions of decision theory and game theory – either the unit of agency or the nature of rationality.
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Tavor, Tchai, and Sharon Garyn-Tal. "Risk tolerance and rationality in the case of retirement savings." Studies in Economics and Finance 33, no. 4 (October 3, 2016): 688–703. http://dx.doi.org/10.1108/sef-10-2015-0240.
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Purpose This research aims to examine the decision-making process involved in saving for retirement and compare it with decision-making processes regarding other financial products (such as loans and savings plans) as well as real products (such as a car or a home). Design/methodology/approach This research is based on the distribution of 107 questionnaires. The questionnaire is composed of two parts: questions examining and focusing on the individual’s decision-making process and questions regarding socioeconomic factors. The average level of risk tolerance is calculated for each respondent with respect to the first four chapters. (These chapters include buying a car or a home, opening a savings plan and taking a loan). Afterward, the consistency (rationality) of the respondents is examined with regard to their decision-making concerning retirement savings plans. Then, an econometric model is used to further test the consistency of the respondents. Findings The results suggest that the level of risk tolerance associated with a retirement savings plan is consistent with that associated with the other financial products, but not with the real products. Majority of the respondents demonstrate high risk tolerance with respect to retirement savings, and their decision-making process is similar to a random thinking process. The level of deliberation and information-gathering regarding retirement savings is the lowest when compared with the other financial and real products examined in this paper. Majority of the respondents are less risk-tolerant toward the other financial and real products. Originality/value In this research, the authors examine how different individuals with different characteristics get different decisions about their personal retirement savings. The authors also examine these decisions’ deviation from the rational model, and compare it with decision-making processes regarding other financial products as well as real products.
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Witteman, Holly O., Ruth Ndjaboue, Gratianne Vaisson, Selma Chipenda Dansokho, Bob Arnold, John F. P. Bridges, Sandrine Comeau, et al. "Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis." Medical Decision Making 41, no. 7 (September 25, 2021): 801–20. http://dx.doi.org/10.1177/0272989x211037946.
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Background Patient decision aids should help people make evidence-informed decisions aligned with their values. There is limited guidance about how to achieve such alignment. Purpose To describe the range of values clarification methods available to patient decision aid developers, synthesize evidence regarding their relative merits, and foster collection of evidence by offering researchers a proposed set of outcomes to report when evaluating the effects of values clarification methods. Data Sources MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, and CINAHL. Study Selection We included articles that described randomized trials of 1 or more explicit values clarification methods. From 30,648 records screened, we identified 33 articles describing trials of 43 values clarification methods. Data Extraction Two independent reviewers extracted details about each values clarification method and its evaluation. Data Synthesis Compared to control conditions or to implicit values clarification methods, explicit values clarification methods decreased the frequency of values-incongruent choices (risk difference, –0.04; 95% confidence interval [CI], –0.06 to –0.02; P < 0.001) and decisional conflict (standardized mean difference, –0.20; 95% CI, –0.29 to –0.11; P < 0.001). Multicriteria decision analysis led to more values-congruent decisions than other values clarification methods (χ2 = 9.25, P = 0.01). There were no differences between different values clarification methods regarding decisional conflict (χ2 = 6.08, P = 0.05). Limitations Some meta-analyses had high heterogeneity. We grouped values clarification methods into broad categories. Conclusions Current evidence suggests patient decision aids should include an explicit values clarification method. Developers may wish to specifically consider multicriteria decision analysis. Future evaluations of values clarification methods should report their effects on decisional conflict, decisions made, values congruence, and decisional regret.
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Manne, Sharon L., Barbara L. Smith, Sara Frederick, Anna Mitarotondo, Deborah A. Kashy, and Laurie J. Kirstein. "B-Sure: a randomized pilot trial of an interactive web-based decision support aid versus usual care in average-risk breast cancer patients considering contralateral prophylactic mastectomy." Translational Behavioral Medicine 10, no. 2 (January 4, 2019): 355–63. http://dx.doi.org/10.1093/tbm/iby133.
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Abstract The use of contralateral prophylactic mastectomy (CPM) is increasing among breast cancer patients who are at average or “sporadic” risk for contralateral breast cancer. Because CPM provides no survival benefit for these patients, it is not medically recommended for them. Decision support aids may facilitate more informed, higher quality CPM decision. The purpose of this study was to evaluate the feasibility and acceptability of B-Sure, an online decision support aid to facilitate informed decisions regarding CPM, and to compare the impact of B-Sure in increasing CPM knowledge, reducing decisional conflict, and increasing preparedness to make the CPM decision among breast cancer patients at sporadic risk who are considering CPM. Ninety-three patients with unilateral, nonhereditary breast cancer considering CPM completed a baseline survey, were randomized to receive B-Sure or Usual care, and completed a 4-week follow-up survey assessing decisional conflict, preparedness to make the CPM decision, and CPM knowledge as well as self-efficacy, perceived risk, worry, CPM motivations, and the surgical decision. Study participation was high. B-Sure was viewed by almost 80% of the participants and was evaluated positively. At follow-up, patients assigned to B-Sure reported significantly higher clarity regarding the personal values relevant to the CPM decision and higher knowledge about CPM. B-Sure had smaller effects on other aspects of decisional conflict. B-Sure improved CPM knowledge and reduced decisional conflict. Patients considering CPM may benefit from an online decision support aid, but may be sensitive to approaches that they perceive as biased against CPM.
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Moroni, Stefano, and Daniele Chiffi. "Uncertainty and Planning: Cities, Technologies and Public Decision-Making." Perspectives on Science 30, no. 2 (2022): 237–59. http://dx.doi.org/10.1162/posc_a_00413.
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Abstract Decision-making under uncertainty is sometimes investigated as a homogeneous problem, independently of the type of decision-maker and the level and nature of the decision itself. However, when the decision-maker is a public authority, there immediately arise problems additional to those that concern any other (private) decision-maker. This is not always clearly recognised in orthodox discussions on decisions under conditions of uncertainty. This article investigates the methodological, strategic and procedural challenges of taking public decisions in such conditions. It focuses mainly on decisions involving urban contexts, such as planning decisions regarding land use and building transformations, by trying to develop some pioneering research studies in this field.
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Samuels, Alec. "Advance decision." Medicine, Science and the Law 47, no. 4 (October 2007): 288–92. http://dx.doi.org/10.1258/rsmmsl.47.4.288.
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In the UK, patients have a statutory right to refuse treatment. Parliament has authorised ‘advance decision’ whereby a person can specify his or her wishes regarding further medical treatment. Although the advance decision may give a person peace of mind, it could create real problems for doctors and other healthcare professionals. This article will examine the conditions and procedures surrounding the drawing up of an advance decision as well as some of the problems that could arise such as layman's language.
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Gallagher, Ann, and Craig Gannon. "Difficult Decisions in Cancer Care — Conducting an Ethics Case Analysis." European Oncology & Haematology 07, no. 02 (2011): 101. http://dx.doi.org/10.17925/eoh.2011.07.02.101.
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In everyday oncology practice, practitioners make a wide range of ethical decisions. Many of these decisions will seem straightforward, with those involved agreeing on the right course of action. Other decisions will be difficult, with conflicting perspectives regarding the wishes, needs and best interests of patients. This article suggests an ethical framework to facilitate the decision-making of practitioners in relation to challenging practice situations. We provide an anonymised ‘ethics case’ to examine one difficult decision made by a hospice team. The four-quadrant approach can be used to facilitate reflection and collaborative decision-making.
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Zavadskas, Edmundas Kazimieras, Artūras Kaklauskas, Audrius Banaitis, and Vaidotas Trinkūnas. "SYSTEM FOR REAL TIME SUPPORT IN CONSTRUCTION MATERIALS SELECTION." International Journal of Strategic Property Management 9, no. 2 (June 30, 2005): 99–109. http://dx.doi.org/10.3846/1648715x.2005.9637531.
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The significant part of the constructions’ value consists of construction materials price. With the aim of using financial resources for the construction effectively, it is very important that well considered and reasonable decisions should be made regarding the selection of construction materials. Most of all construction on‐line systems seek to find how to make the most economic construction decisions and essentially these decisions are intended only for economic objectives. Construction alternatives that are under evaluation have to be evaluated not only from the economic position, but also take into consideration qualitative, technical, technological and other characteristics. Additionally, in seeking to facilitate the work of decision‐makers, computer technologies are used that operates according to particular models. These models are based on special mathematical methods in order to facilitate decision‐making and apply to a certain decision area. In this article, the possibilities of applying methods for popular decision‐making are analyzed regarding the selection of construction materials.
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Lognon, Tania, Amédé Gogovor, Karine V. Plourde, Paul Holyoke, Claudia Lai, Emmanuelle Aubin, Kathy Kastner, et al. "Predictors of Decision Regret among Caregivers of Older Canadians Receiving Home Care: A Cross-Sectional Online Survey." MDM Policy & Practice 7, no. 2 (July 2022): 238146832211163. http://dx.doi.org/10.1177/23814683221116304.
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Background. In Canada, caregivers of older adults receiving home care face difficult decisions that may lead to decision regret. We assessed difficult decisions and decision regret among caregivers of older adults receiving home care services and factors associated with decision regret. Methods. From March 13 to 30, 2020, at the outbreak of the COVID-19 pandemic, we conducted an online survey with caregivers of older adults receiving home care in the 10 Canadian provinces. We distributed a self-administered questionnaire through Canada’s largest and most representative private online panel. We identified types of difficult health-related decisions faced in the past year and their frequency and evaluated decision regret using the Decision Regret Scale (DRS), scored from 0 to 100. We performed descriptive statistics as well as bivariable and multivariable linear regression to identify factors predicting decision regret. Results. Among 932 participants, the mean age was 42.2 y (SD = 15.6 y), and 58.4% were male. The most frequently reported difficult decisions were regarding housing and safety (75.1%). The mean DRS score was 28.8/100 (SD = 8.6). Factors associated with less decision regret included higher caregiver age, involvement of other family members in the decision-making process, wanting to receive information about the options, and considering organizations interested in the decision topic and health care professionals as trustworthy sources of information (all P < 0.001). Factors associated with more decision regret included mismatch between the caregiver’s preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care (all P < 0.001). Discussion. Decisions about housing and safety were the difficult decisions most frequently encountered by caregivers of older adults in this survey. Our results will inform future decision support interventions. Highlights This is one of the first studies to assess decision regret among caregivers of older adults receiving home and community care services and to identify their most frequent difficult decisions. Difficult decisions were most frequently about housing and safety. Most caregivers of older adults in all 10 provinces of Canada experienced decision regret. Factors associated with less decision regret included higher caregiver age, the involvement of other family members in the decision-making process, wanting to receive information about the options, considering organizations interested in the decision topic, and health care professionals as trustworthy sources of information. Factors associated with more decision regret included mismatch between the caregiver’s preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care.
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Ito, Takehiro, Akihiro Suzuki, Toru Takemoto, Kazuhito Ogawa, and Hiromasa Takahashi. "Contagion of Self-Interested Behavior: Evidence from Group Dictator Game Experiments." German Economic Review 17, no. 4 (December 1, 2016): 425–37. http://dx.doi.org/10.1111/geer.12077.
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Abstract We examine how group decision-making affects other-regarding behavior in experimental dictator games. In particular, we assess whether the effects of iterated games differ for group and individual decision-making and whether the difference in decision-making style (individual or group) changes the perception of social identity. We make two findings on group decision-making. First, group decisions become more selfish when repeating the game after changing group members. Second, a dictator group donates more to a recipient group at the same university than to a recipient group at a different university. These findings are not true for individual decision-making.
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Haial, Afaf, Loubna Benabbou, and Abdelaziz Berrado. "Designing a Transportation-Strategy Decision-Making Process for a Supply Chain: Case of a Pharmaceutical Supply Chain." International Journal of Environmental Research and Public Health 18, no. 4 (February 21, 2021): 2096. http://dx.doi.org/10.3390/ijerph18042096.
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Including an active participation of stakeholders along the transportation decision-making process is increasingly recognized as a necessary condition for reaching successful and high-quality decisions. This paper presents a framework for deciding on the appropriate transportation strategy for a supply chain from a multistakeholder perspective. It consists of three steps: (1) defining the transportation-strategy decision-making context and the objectives that must be achieved; (2) analyzing the actual transportation strategy regarding its three components: transportation network; transportation mode; and transportation insource/outsource, as well as identifying the stakeholders interested in the study; and (3) conducting a group decision making regarding each transportation strategy’s component, while involving the key stakeholders and taking into account the specificities of transported products. The proposed framework is then applied to a real case of the Moroccan public pharmaceutical supply chain, which has different features that distinguish it from other supply chains including its importance, urgency, and regulation. We employed the DELPHI method to determine the key stakeholders that should be involved in the decisional process. After that, we applied the group AHP method for selecting the appropriate transport-network design option while involving the identified key stakeholders.
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Beryl, Louise L., Katharine A. S. Rendle, Meghan C. Halley, Katherine A. Gillespie, Suepattra G. May, Jennifer Glover, Peter Yu, Runi Chattopadhyay, and Dominick L. Frosch. "Mapping the Decision-Making Process for Adjuvant Endocrine Therapy for Breast Cancer." Medical Decision Making 37, no. 1 (July 10, 2016): 79–90. http://dx.doi.org/10.1177/0272989x16640488.
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Background. Studies show adjuvant endocrine therapy increases survival and decreases risk of breast cancer recurrence for hormone receptor–positive tumors. Yet studies also suggest that adherence rates among women taking this therapy may be as low as 50% owing largely to adverse side effects. Despite these rates, research on longitudinal patient decision making regarding this therapy is scant. Objective. We sought to map the decision-making process for women considering and initiating adjuvant endocrine therapy, paying particular attention to patterns of uncertainty and decisional change over time. Methods. A longitudinal series of semistructured interviews conducted at a multispecialty health care organization in Northern California with 35 newly diagnosed patients eligible for adjuvant endocrine therapy were analyzed. Analysis led to the identification and indexing of 3 new decision-making constructs—decisional phase, decisional direction, and decisional resolve—which were then organized using a visual matrix and examined for patterns characterizing the decision-making process. Results. Our data reveal that most patients do not make a single, discrete decision to take or not take hormone therapy but rather traverse multiple decisional states, characterized by 1) phase, 2) direction, and 3) strength of resolve. Our analysis tracks these decisional states longitudinally using a grayscale-coded matrix. Our data show that decisional resolve wavers not just when considering therapy, as the existing concept of decisional conflict suggests, but even after initiating it, which may signal future decisions to forgo therapy. Conclusions. Adjuvant endocrine therapy, like other chronic care decisions, has a longer decision-making process and implementation period. Thus, theoretical, empirical, and clinical approaches should consider further exploring the new concept and measurement of decisional resolve, as it may help to improve subsequent medication adherence.
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Oxoby, Robert J., and Kendra N. McLeish. "Sequential decision and strategy vector methods in ultimatum bargaining: evidence on the strength of other-regarding behavior." Economics Letters 84, no. 3 (September 2004): 399–405. http://dx.doi.org/10.1016/j.econlet.2004.03.011.
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Szymanski, Antonia (Toni). "High Expectations, Limited Options: How Gifted Students Living in Poverty Approach the Demands of AP Coursework." Journal for the Education of the Gifted 44, no. 2 (April 2, 2021): 149–70. http://dx.doi.org/10.1177/01623532211001443.
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The aim of this study was to explore the lived experiences of advanced students who live in poverty and their choices regarding taking Advanced Placement (AP) courses. Ten urban high school students were interviewed regarding their decision-making process regarding coursework to investigate supports or barriers that exist. Four themes became apparent: Gifted students take advanced classes for challenge and to decrease boredom; internalized messages about what it means to be smart influenced decisions regarding taking advanced classes; external influences could apply positive or negative pressure that affect the decision to take AP courses; and it is difficult for gifted students to find balance between the stress of the AP workload and time management with working and trying to fit in other interests. The themes reflected the complex interplay of internal and external forces that influence whether or not students take AP courses regardless of high academic ability.
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Perez-Benitez, Virginia, German Gemar, and Mónica Hernández. "Multi-Criteria Analysis for Business Location Decisions." Mathematics 9, no. 20 (October 17, 2021): 2615. http://dx.doi.org/10.3390/math9202615.
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Choosing the physical place in which to locate a company or make investments is a strategic decision that managers must make when their business activities begin and as they expand. These decisions are key to firms’ survival. This study sought to shed light on this decision problem and assist managers in making these decisions. The first research objective was to examine the different dimensions that decision makers should consider regarding locations. The second objective was to test the efficacy of multi-criteria analysis methods regarding this decision problem. More specifically, this study applied a combination of the preference ranking organization method for enrichment of evaluations and the geometric analysis for interactive aid method, complemented by the analytical hierarchy process. The last objective was to rank major European cities on their suitability as business locations. The results include a preferential ranking of 66 European cities. London is the best positioned in all dimensions, followed by Paris and Barcelona. The findings’ originality comes from the inclusion of dimensions such as climate, security, and technology, which are given little weight in other similar indices, as well as the fresh approach to this decision problem from a business perspective and the combination of methodologies.
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Bakshi, Nitya, Cynthia Sinha, Diana Ross, Kirshma Khemani, George Loewenstein, and Lakshmanan Krishnamurti. "Shared Decision Making or Physician Advocate for a Particular Treatment Option: A Spectrum of Approaches to Decision Making about Disease Modifying Therapies in Sickle Cell Disease." Blood 128, no. 22 (December 2, 2016): 4757. http://dx.doi.org/10.1182/blood.v128.22.4757.4757.
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Abstract Background The decision-making process regarding therapeutic options in Sickle Cell Disease (SCD) can be complex. Disease modifying therapies such as hydroxyurea (HU), bone marrow transplantation (BMT) or chronic blood transfusion (CBT) are heterogeneous in their therapeutic intent, efficacy in preventing progression of disease, costs, acute complications, patient burden and long-term side effects. Both healthcare provider and patient-related factors may influence decision-making regarding these treatment options. That a majority of patients with SCD belong to minority underserved populations adds to the complexity of the decision-making in this group of patients. Shared decision making (SDM), a collaborative process that allows patients and their providers to make health care decisions together is preferred since it takes into account the best clinical evidence available, as well as the patient's values and preferences. There is a paucity of data on how physicians approach their conversations with patients regarding therapeutic options. The objective of this study was to determine the perspective of physicians with expertise in SCD and BMT regarding decision making about disease modifying therapy. Methods We enrolled a geographically diverse and nationally representative sample of physicians with expertise in the clinical management of SCD in this mixed methods study. We conducted and analyzed qualitative interviews focused on the physician perspective of patients' values, preferences and decisional needs in decision making regarding disease-modifying therapeutic options in SCD. These interviews were part of a larger study to understand decisional needs of patients with SCD in order to develop a decision aid for the therapeutic options in SCD. Open-ended semi-structured interviews were used to collect data. All interviews were recorded and transcribed verbatim. We used NVivo10 for analysis of qualitative data. We sought to understand the framework of discussion used by physicians for the various therapeutic options. Our analysis concentrated on how physicians engaged in discussions related to therapeutic options to reveal whether physicians facilitate the patient's decision process or intend to convince the patient of a treatment plan. Results We interviewed 37 physicians who were experts in pediatric or adult SCD or BMT. Twenty of the 37 were female. Physician narratives reflected high concern for the well-being of the patient and caregivers. Using content analysis, we categorized the physicians' narratives on a spectrum based on their degree of involvement in guiding decision making regarding disease modifying therapies. Narratives placed on one end of the spectrum were those where the physician frequently discussed patient involvement in the decision-making process. On the other end of the spectrum, we categorized physicians who were explicitly advocating for a particular treatment plan for the patient. Thus, the assumption was that this latter group of physicians entered into physician-patient conversations with a recommended therapeutic plan. We further analyzed the content of this spectrum to reveal what patient attributes influenced the physician's narrative. While all of the physicians in our study were advocates of patient education and active involvement, more than half of the narratives were explicitly promoting a particular therapeutic plan. Our analysis revealed that the degree of physician involvement was influenced by the perception of patient compliance, socio-economic barriers, and the patient's current clinical condition. Physicians who advocated a treatment option were more likely to discuss patient non-compliance and barriers as influencing their treatment decision. Moreover, many of these physicians were less likely to discuss all available treatment options, such as BMT. Conclusions Decision making regarding disease modifying therapy in SCD is complex and the approach of physicians ranges from SDM model to that of a physician advocating for a particular treatment. These data suggest the need for greater awareness of and education about the SDM model for patients and physicians. They provide the rationale for creating of decision support systems regarding disease-modifying therapies for SCD. Disclosures No relevant conflicts of interest to declare.
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Schettini, Irene, Gabriele Palozzi, and Antonio Chirico. "Enhancing Healthcare Decision-Making Process: Findings from Orthopaedic Field." Administrative Sciences 10, no. 4 (November 25, 2020): 94. http://dx.doi.org/10.3390/admsci10040094.
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In the healthcare field, the decision-making process is part of the broad spectrum of “clinical reasoning”, which is recognised as the whole process by which a physician decides about patients’ treatments and cares. Several clinicians’ intrinsic variables lead to this decisional path. Little is known about the inference of these variables in triggering biases in decisions about the post-discharge period in the surgical field. Accordingly, this research aims to understand if and how cognitive biases can affect orthopaedists in decision-making regarding the follow-up after knee and hip arthroplasty. To achieve this goal, an interview-based explorative case study was run. Three key-decisional orthopaedic surgeons were interviewed through a quality control tool aimed at monitoring the causes and effects of cognitive distortions. Coherently with the literature, eight biases come to light. All the interviewees agree on the presence of four common biases in orthopaedic surgery (Affect heuristic, Anchoring, Halo effect, Saliency). The other biases (Groupthink, Availability, Overconfidence, Confirmation), instead, depending on specific physicians’ intrinsic variables; namely: (i) working experience; (ii) working context. This finding contributes to the debate about the application of cognitive tools as leverage for improving the quality of clinical decision-making process and, indirectly, enhancing better healthcare outcomes.
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Bowen, Emily, Rabih Nayfe, Nathaniel Milburn, Helen Mayo, M. C. Reid, Liana Fraenkel, Debra Weiner, Ethan A. Halm, and Una E. Makris. "Do Decision Aids Benefit Patients with Chronic Musculoskeletal Pain? A Systematic Review." Pain Medicine 21, no. 5 (December 27, 2019): 951–69. http://dx.doi.org/10.1093/pm/pnz280.
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Abstract Objective To review the effect of patient decision aids for adults making treatment decisions regarding the management of chronic musculoskeletal pain. Methods We performed a systematic review of randomized controlled trials of adults using patient decision aids to make treatment decisions for chronic musculoskeletal pain in the outpatient setting. Results Of 477 records screened, 17 met the inclusion criteria. Chronic musculoskeletal pain conditions included osteoarthritis of the hip, knee, or trapeziometacarpal joint and back pain. Thirteen studies evaluated the use of a decision aid for deciding between surgical and nonsurgical management. The remaining four studies evaluated decision aids for nonsurgical treatment options. Outcomes included decision quality, pain, function, and surgery utilization. The effects of decision aids on decision-making outcomes were mixed. Comparing decision aids with usual care, all five studies that examined knowledge scores found improvement in patient knowledge. None of the four studies that evaluated satisfaction with the decision-making process found a difference with use of a decision aid. There was limited and inconsistent data on other decision-related outcomes. Of the eight studies that evaluated surgery utilization, seven found no difference in surgery rates with use of a decision aid. Five studies made comparisons between different types of decision aids, and there was no clearly superior format. Conclusions Decision aids may improve patients’ knowledge about treatment options for chronic musculoskeletal pain but largely did not impact other outcomes. Future efforts should focus on improving the effectiveness of decision aids and incorporating nonpharmacologic and nonsurgical management options.
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Kabir, Russell, Angi Alradie-Mohamed, Nahida Ferdous, Divya Vinnakota, S. M. Yasir Arafat, and Ilias Mahmud. "Exploring Women’s Decision-Making Power and HIV/AIDS Prevention Practices in South Africa." International Journal of Environmental Research and Public Health 19, no. 24 (December 10, 2022): 16626. http://dx.doi.org/10.3390/ijerph192416626.
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Decisions regarding sexual and reproductive health significantly impact women’s health and their protection against HIV/AIDS and other sexually transmitted infections. These decisions also impact females’ ability to reach their reproductive goals. Women’s autonomy is recognized to be vital to women’s access to reproductive healthcare, the use of contraceptives, the capacity to avoid or receive treatment for STIs (including HIV), and other reproductive and sexual health issues. This research investigated the association between the decision-making power of South African women (of reproductive age) and their knowledge and practices regarding HIV/AIDS preventive measures. The present study used data from the South Africa Demographic and Health Survey 2016. A total of 8514 women aged 15–49 years who participated in the survey were used for this research. The mean age of the women was 30.21 years, with an SD of 9.86. Approximately 38.5% of the women decided on contraceptive use, and only 11.7% of women’s partners and 49.8% of respondents were jointly involved in the decision-making process of contraceptive use. All HIV preventive measures under study were statistically significantly associated with high decision-making power; the use of a condom by the husband or partner of the women was the most significant; husbands or partners of the women with high autonomy were three times more likely to use condoms.
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Longoni, Chiara, Andrea Bonezzi, and Carey K. Morewedge. "Resistance to medical artificial intelligence is an attribute in a compensatory decision process: response to Pezzo and Beckstead (2020)." Judgment and Decision Making 15, no. 3 (May 2020): 446–48. http://dx.doi.org/10.1017/s1930297500007233.
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AbstractIn Longoni et al. (2019), we examine how algorithm aversion influences utilization of healthcare delivered by human and artificial intelligence providers. Pezzo and Beckstead’s (2020) commentary asks whether resistance to medical AI takes the form of a noncompensatory decision strategy, in which a single attribute determines provider choice, or whether resistance to medical AI is one of several attributes considered in a compensatory decision strategy. We clarify that our paper both claims and finds that, all else equal, resistance to medical AI is one of several attributes (e.g., cost and performance) influencing healthcare utilization decisions. In other words, resistance to medical AI is a consequential input to compensatory decisions regarding healthcare utilization and provider choice decisions, not a noncompensatory decision strategy. People do not always reject healthcare provided by AI, and our article makes no claim that they do.
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Mailin, Mailin, Gepeng Rambe, Abdi Ar-Ridho, and Candra Candra. "TEORI MEDIA/TEORI DIFUSI INOVASI." Jurnal Guru Kita PGSD 6, no. 2 (March 12, 2022): 168. http://dx.doi.org/10.24114/jgk.v6i2.31905.
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This study aims to examine the theory of diffusion of innovation, the method of this research is library research, the results of this study are: The process of adopting innovation through several stages so that there is a public decision to accept and reject innovation. 1. The knowledge stage where the community obtains a number of information or knowledge, functions, benefits and various things regarding innovation from various information channels, including: friends, family, neighbors, and the mass media. 2. Then the community began to give both positive and negative attitudes, here there was a search for additional information from various communication channels. Communication channels make a big enough contribution to the spread of innovation to the community, interpersonal communication channels are more commonly found when there is a spread of innovation. 3. Next is the decision stage, namely the decision to adopt or reject the innovation, so that in the decision process there are people who adopt, that is, fully use the innovation and some reject the innovation. In making decisions, people tend to consider the relative advantages of innovation, which can be seen from the speed of healing, low and affordable costs, the suitability of the innovation to the needs of the community, as evidenced by observations by other people regarding the advantages of innovation, location affordability and perceptions of information. 4. The implementation stage is that people who choose to adopt will carry out their decisions by coming to the treatment of sangkal putung, on the other hand, people who refuse will also carry out the decisions they have chosen. 5. The last stage is the confirmation process in which the community assesses that the chosen decision is correct or not.
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Kleinmuntz, Don N., and David A. Schkade. "Information Displays and Decision Processes." Psychological Science 4, no. 4 (July 1993): 221–27. http://dx.doi.org/10.1111/j.1467-9280.1993.tb00265.x.
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Information displays influence decision processes by facilitating some decision strategies while hindering others. Component characteristics of displays, such as the form, organization, and sequence of information, influence decision processes through an adaptive mechanism whereby a decision maker balances the desire to maximize accuracy against the desire to minimize effort. Variations in the information display lead to changes in the anticipated effort and anticipated accuracy of each available strategy and, therefore, provide an incentive for decision makers to use different decision processes. Research in this area can provide guidance regarding the use of displays and other decision-aiding approaches.
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Constantinescu, Maria. "The Relevance of Defence Expenditures as an Indicator of a Country’s Military Power." International conference KNOWLEDGE-BASED ORGANIZATION 26, no. 1 (June 1, 2020): 196–204. http://dx.doi.org/10.2478/kbo-2020-0032.
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AbstractThe level defence expenditures is a useful indicator for cross-country comparisons and for the analysis of the trends regarding defence expenditures per country, region or groups of countries. Decision makers often refer to past trends for defence expenditures or the level of defence expenditures for a perceived enemy country to justify political decisions. Still, the data regarding defence expenditures should not be considered the ultimate indicator regarding a country’s military strength and decision makers should be aware of the limitations and underlying assumptions of the methods used to quantify defence expenditures. The most used methods of estimating defence expenditures are based on the exchange rates and the purchasing power parity, with several advantages and disadvantages. While these type of statistics do offer a broad image on the defence expenditures of other countries, they are not a substitute for more in-depth analyses regarding the security and defence environment, the real military strength of perceived foes and a sound strategy for the long term development of the own forces.
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Jayasuriya, P., Y. Amanullah, A. Kumar, and C. Hookey. "55 Quality Improvement Project to Assess How Informed Patients are About do not Attempt Cardiopulmonary (DNACPR) Decisions?" Age and Ageing 49, Supplement_1 (February 2020): i14—i17. http://dx.doi.org/10.1093/ageing/afz186.09.
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Abstract Introduction Despite growing evidence regarding DNACPR decisions, there is a paucity of information given to patients regarding resuscitation decisions. The main aim of this quality improvement project was to assess and improve patients’ and their relatives’ understanding about DNACPR decisions. Intervention We initially surveyed 30 inpatients or their next-of-kin (if the patient lacked capacity) in a geriatric ward who had DNACPR decisions in place. Although, 86% knew the implications of a DNACPR decision, only 50% knew that a DNACPR decision would not limit them from receiving other treatment. 66% reported that the information given by the healthcare professional is “too little”. 35 questionnaires were also given to doctors of all grades to assess their practice of DNACPR discussions and barriers for discussion. Majority (95%) of doctors knew what should be included in a DNACPR discussion. Medical staff not considering DNACPR discussions during assessment, medical staff not comfortable to make the DNACPR decision and the fear of distressing the patient are the three main issues that were highlighted as barriers. 17% of doctors reported that they would have attended a cardiac arrest at least on 2-5 occasions for a patient when resuscitation was futile. We presented this data and educated doctors on effective DNACPR discussions using video demonstrations in weekly journal clubs. All doctors were informed to distribute DNACPR Improvement After the intervention, only 80% understood the DNACPR discussion. 76% knew that DNACPR does not limit them from receiving other treatment. 73% reported that this was not stressful and 76% were satisfied with the discussion and reported that their questions were answered adequately. 11 out of 30 patients had received the information leaflets and all found it useful. Discussion Although after the intervention the percentage who understood the DNACPR decision had reduced compared to the initial audit, there was a 20% improvement in who knew that DNACPR decisions did not limit other treatment. We hope to extend this study by carrying out training sessions for doctors to improve the quality of these conversations and thereby enhance adherence to expected practice in DNACPR decision making.
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Johnson, Sterling C., Taylor W. Schmitz, Tisha N. Kawahara-Baccus, Howard A. Rowley, Andrew L. Alexander, Jonghoon Lee, and Richard J. Davidson. "The Cerebral Response during Subjective Choice with and without Self-reference." Journal of Cognitive Neuroscience 17, no. 12 (December 2005): 1897–906. http://dx.doi.org/10.1162/089892905775008607.
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The anterior medial prefrontal (AMPFC) and retrosplenial (RSC) cortices are active during self-referential decision-making tasks such as when participants appraise traits and abilities, or current affect. Other appraisal tasks requiring an evaluative decision or mental representation, such as theory of mind and perspective-taking tasks, also involve these regions. In many instances, these types of decisions involve a subjective opinion or preference, but also a degree of ambiguity in the decision, rather than a strictly veridical response. However, this ambiguity is generally not controlled for in studies that examine self-referential decision-making. In this functional magnetic resonance imaging experiment with 17 healthy adults, we examined neural processes associated with subjective decision-making with and without an overt self-referential component. The task required subjective decisions about colors-regarding self-preference (internal subjective decision) or color similarity (external subjective decision) under conditions where there was no objectively correct response. Results indicated greater activation in the AMPFC, RSC, and caudate nucleus during internal subjective decision-making. The findings suggest that self-referential processing, rather than subjective judgments among ambiguous response alternatives, accounted for the AMPFC and RSC response.
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Radonjic, Ognjen. "Fundamental uncertainty and Keynes' probability theory." Theoria, Beograd 50, no. 4 (2007): 35–55. http://dx.doi.org/10.2298/theo0704035r.
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Within economic system agents daily make decisions. Those decisions are based on their expectations regarding future. Therefore, theoretical assumption about what do rational decision-makers really know about future and could agents make relatively reliable forecasts has colossal importance. Namely this assumption critically determines theoretical modeling of decision-making process. In economic theory we can make distinction between two opposite and irreconcilable standpoints on this issue. According to proponents of the Subjective Probability and the Rational Expectations Hypothesis future can be predicted exactly, that is, agents are able to mathematically calculate future precisely and to express it in terms of numbers. Consistently behavior of individual agent and society in aggregate can be predicted with great precision. On the other hand, Keynes, first economist who made clear distinction between risk and uncertainty, argued that past experiences and statistical analysis of past data were not reliable guide to future and that behavior of individual agents and society in aggregate could not be neither calculated exactly nor precisely predicted. Consequently, theoretical implications regarding decision-making and behavior of aggregate economic system of the two opposite standpoints are completely different.
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Sockolow, Paulina S., Kathryn H. Bowles, Carl Pankok, Yingjie Zhou, Sheryl Potashnik, and Ellen J. Bass. "Planning the Episode: Home Care Admission Nurse Decision-Making Regarding the Patient Visit Pattern." Home Health Care Management & Practice 33, no. 3 (February 1, 2021): 193–201. http://dx.doi.org/10.1177/1084822321990775.
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During home health care (HHC) admissions, nurses provide input into decisions regarding the skilled nursing visit frequency and episode duration. This important clinical decision can impact patient outcomes including hospitalization. Episode duration has recently gained greater importance due to the Centers for Medicare and Medicaid Services (CMS) decrease in reimbursable episode length from 60 to 30 days. We examined admissions nurses’ visit pattern decision-making and whether it is influenced by documentation available before and during the first home visit, agency standards, other disciplines being scheduled, and electronic health record (EHR) use. This observational mixed-methods study included admission document analysis, structured interviews, and a think-aloud protocol with 18 nurses from 3 diverse HHC agencies (6 at each) admitting 2 patients each (36 patients). Findings show that prior to entering the home, nurses had an information deficit; they either did not predict the patient’s visit frequency and episode duration or stated them based on experience with similar patients. Following patient interaction in the home, nurses were able to make this decision. Completion of documentation using the EHR did not appear to influence visit pattern decisions. Patient condition and insurance restrictions were influential on both frequency and duration. Given the information deficit at admission, and the delay in visit pattern decision making, we offer health information technology recommendations on electronic communication of structured information, and EHR documentation and decision support.
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Usher, Ruth, and Tadhg Stapleton. "27 Decision-Making Capacity Assessment: Occupational Therapy’s Contribution within a Multidisciplinary Approach." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.17.
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Abstract Background Increasing age and life expectancy, alongside the growing incidence of chronic conditions and dementia-related diseases, indicate more older individuals are likely to experience challenges regarding decision-making capacity. In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statuary framework for adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care, especially those working with older adults. An online survey was conducted to explore occupational therapy practices regarding decision-making capacity assessment and factors impacting on engagement in this area. Methods Occupational therapists in Ireland were invited to participate in a cross-sectional online questionnaire. Results One hundred and seventy-two occupational therapists responded. Most occupational therapists (65.77%, n=98) reported involvement in decision-making capacity assessments, particularly those working with older adults. Occupational therapists were more frequently requested to contribute to assessments of capacity regarding independent living (79.19%, n=118), driving (45.89%, n=67), and financial management (44.44%, n=64). Occupational therapists reported using a combination of approaches to inform decision-making capacity assessment, including interviews, observations and assessments of cognition and functional performance, and emphasised a strength-based approach. Many participants reported decision-making capacity assessment is more difficult than other aspects of practice and that they are not satisfied with decision-making capacity assessment procedures in their workplace. A large majority (91.86%, n=113) reported occupational therapists would benefit from additional training and practice resources for decision-making capacity assessment. Conclusion The study confirms that occupational therapists have a role to play in assessment of decision-making capacity assessment, particularly regarding independent living. However, the recommended approach to assessment should include all appropriate multidisciplinary team members. There is need for further education, resources and guidelines for occupational therapists and other healthcare professionals to better guide decision-making capacity assessment.
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Kogut, Tehila, and Momi Dahan. "Do you look forward to retirement? Motivational biases in pension decisions." Judgment and Decision Making 7, no. 3 (May 2012): 282–91. http://dx.doi.org/10.1017/s1930297500002254.
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AbstractThis research examines the relationship between positive and negative perceptions of pensions and motivation to engage in the decision process of choosing a private pension plan, as well as satisfaction from the chosen pension plan, among trained economists. A sample of 134 economists completed a self-report survey examining the decision process of different decision contexts in life, including pension decisions. Overall, participants showed low motivation to engage in the process of choosing a private pension plan, compared to their motivation to engage in other decision tasks. However, economists invested more in the decision process and showed greater satisfaction from their decision regarding their pension plan when they had a more positive perception of pensions. This perception is represented by higher subjective likelihood of receiving pension allowances for a long period, and by a profitable view of the balance between current payments and expected incomes from pension saving.
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Dewi, Fitriana, Listyowati Rahayu, and Unna Safitri. "PENGARUH HARGA DAN KUALITAS PELAYANAN TERHADAP KEPUTUSAN PEMBELIAN KONSUMEN (Studi Kasus Pada CV. XP Computer, Boyolali)." EKOBIS : Jurnal Ilmu Manajemen dan Akuntansi 8, no. 1 (June 23, 2020): 14–24. http://dx.doi.org/10.36596/ekobis.v8i1.262.
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Based on the results of the study note that the price of a partial no effect on purchasing decisions this is evidenced by the value of t count < t table it’s about -0.2243 <1.984. As for the quality of service is known that the partial effect on purchasing decisions. This is evidenced in the grain of service quality regarding the reliability and assurance that the value of tcount > ttable 3.986> 1.984 and 2.011> 1.984. Determination test result there is influence between price and quality of service to decision of purchase equal to 38% whereas 62% influenced by other factor not examined in this research.
Keywords: Price, Service Quality, Purchase Decision
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Lamp, Sandy A., Kathleen M. Hargiss, and Caroline Howard. "Information Technology Process Improvement Decision-Making." International Journal of Strategic Information Technology and Applications 3, no. 2 (April 2012): 18–35. http://dx.doi.org/10.4018/jsita.2012040102.
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This article is derived from a qualitative multicase study with two settings that explored the way decisions are made in two IT organizations regarding process improvement initiatives by using face-to-face semi-structured interviews with 20 IT process owners and managers. The two participating organizations are a healthcare insurance company and a manufacturer of electronic interconnects. The study sought to uncover (a) how IT process improvements are prioritized and how approvals are attained, (b) how senior leadership is involved in decision making, (c) how security and risk are considered, (d) if and how formal process improvement methodologies are used, (e) if and how estimated and actual cost benefit analysis are conducted associated with decisions, and (f) how alignment with organizational goals is attained. The topic of IT governance was narrowed to explore the perspective of IT process owners and process managers, and their approaches and methodologies used with IT process improvement initiatives. The study found that pre-decision stages take place in IT investment decision making, and that process owners and process managers, participants other than senior leadership, and executive level decision makers are involved in these pre-decision stages and may be involved in the final decision stages.
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Manurung, Saut Parulian. "Inconsistent Constitutional Court Decisions Resulting in Uncertainty Regarding the Legal Dispute on Regional Head Election Results in Indonesia." Lentera Hukum 6, no. 2 (July 31, 2019): 317. http://dx.doi.org/10.19184/ejlh.v6i2.11131.
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In Indonesia, the Constitutional Court is the sole interpreter and guardian of the constitution and the decision made by this Court is expected to meet a sense of justice, utility, and legal certainty. This paper argues that there is a contradiction between two decisions ruled by the Court resulted in inconsistent constitutional interpretations. Such inconsistency can be referred to the decision of the Constitutional Court Number 072-073/PUU-II/2004 declaring the Constitutional Court to have the power to adjudicate disputes over the results of regional head elections, while on the other hand, the decision of the Constitutional Court Number 97/PUU-XI/2013 ruled this institution no longer to adjudicate disputes over the results of regional head elections by revoking Article 236C of the revised Regional Government Act No. 12/2008. In doing so, this paper analyzes the impact of such contradictory decisions on uncertainty in the legal dispute regarding regional head election results. This paper concludes that such inconsistency was caused by the application of two different approaches: the first decision applied judicial activism and the latter considered judicial restraint.
Keywords: Constitutional Interpretation, Judicial Restraint, Judicial Activism.
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Cochrane, Thomas. "Ethical Issues in the Neurology of Pregnancy." Seminars in Neurology 37, no. 06 (December 2017): 724–28. http://dx.doi.org/10.1055/s-0037-1607311.
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AbstractDecision making for pregnant women and fetuses who suffer brain injuries is emotionally difficult and conceptually challenging. Occasionally, both the pregnant woman and the fetus have suffered an injury that confers a poor neurological prognosis, and decisions about one of them will have implications for the other—making the process of decision making even more problematic. In this article, decision-making standards and principles are reviewed for both pregnant women and fetuses, using a real case from the author's institution. Practical suggestions are made regarding deliberative processes and consultative models that can help with these difficult cases.
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Dagla, Maria, Vasiliki Petousi, and Antonios Poulios. "Bioethical Decisions in Neonatal Intensive Care: Neonatologists’ Self-Reported Practices in Greek NICUs." International Journal of Environmental Research and Public Health 17, no. 10 (May 15, 2020): 3465. http://dx.doi.org/10.3390/ijerph17103465.
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This study presents, for the first time, empirical data on practices regarding bioethical decision-making in treatment of preterm and ill newborns in Greece. The aim of the study was to: (a) record self-reported practices and involvement of Greek physicians in decisions of withholding and withdrawing neonatal intensive care, and (b) explore the implication of cultural, ethical, and professional parameters in decision-making. Methods: 71 physicians, employed fulltime in all public Neonatal Intensive Care Units (NICUs) (n = 17) in Greece, completed an anonymous questionnaire between May 2009 and May 2011. Results: One-third of the physicians in our sample admitted that they have, at least once in the past, decided the limitation of intensive care of a newborn close to death (37.7%) and/or a newborn with unfavorable neurological prognosis (30.8%). The higher the physicians’ support towards the value of quality of human life, the more probable it was that they had taken a decision to withhold or withdraw neonatal intensive care (p < 0.05). Conclusions: Our research shows that Greek NICU physicians report considerably lower levels of ethical decision-making regarding preterm and ill newborns compared to their counterparts in other European countries. Clinical practices and attitudes towards ethical decision-making appear to be influenced mainly by the Greek physicians’ values.
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Nuranti, Eka Qadri, Evi Yulianti, and Husna Sarirah Husin. "Predicting the Category and the Length of Punishment in Indonesian Courts Based on Previous Court Decision Documents." Computers 11, no. 6 (May 30, 2022): 88. http://dx.doi.org/10.3390/computers11060088.
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Among the sources of legal considerations are judges’ previous decisions regarding similar cases that are archived in court decision documents. However, due to the increasing number of court decision documents, it is difficult to find relevant information, such as the category and the length of punishment for similar legal cases. This study presents predictions of first-level judicial decisions by utilizing a collection of Indonesian court decision documents. We propose using multi-level learning, namely, CNN+attention, using decision document sections as features to predict the category and the length of punishment in Indonesian courts. Our results demonstrate that the decision document sections that strongly affected the accuracy of the prediction model were prosecution history, facts, legal facts, and legal considerations. The prediction of the punishment category shows that the CNN+attention model achieved better accuracy than other deep learning models, such as CNN, LSTM, BiLSTM, LSTM+attention, and BiLSTM+attention, by up to 28.18%. The superiority of the CNN+attention model is also shown to predict the punishment length, with the best result being achieved using the ‘year’ time unit.
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Chiang, Ching-Chun, Shu-Chuan Chang, and Sheng-Yu Fan. "The Concerns and Experience of Decision-Making Regarding Do-Not-Resuscitate Orders Among Caregivers in Hospice Palliative Care." American Journal of Hospice and Palliative Medicine® 38, no. 2 (June 17, 2020): 123–29. http://dx.doi.org/10.1177/1049909120933535.
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A do-not-resuscitate (DNR) order is an important end-of-life decision. In Taiwan, family caregivers are also involved in this decision-making process. This study aimed to explore the concerns and experiences regarding DNR decisions among caregivers in Taiwan. Qualitative study was conducted. Convenience sampling was used, and 26 caregivers were recruited whose patients had a DNR order and had received hospice care or hospice home care. Semi-structured interviews were used for data collection, including the previous experiences of DNR discussions with the patients and medical staff and their concerns and difficulties in decision-making. The data analysis was based on the principle of thematic analysis. Four themes were identified: (1) Patients: The caregivers respected the patients’ willingness and did not want to make them feel like “giving up.” (2) Caregivers’ self: They did not want to intensify the patients’ suffering but sometimes found it emotionally difficult to accept death. (3) Other family members: They were concerned about the other family members’ opinions on DNR orders, their blame, and their views on filial impiety. (4) Medical staff: The information and suggestions from the medical staff were foundational to their decision-making. The caregivers needed the health care professionals’ supports to deal with the concerns from patients and other family members as well as their emotional reactions.
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Walakumbura, S. H. M. L. "The Effect of Financial Literacy on Personal Investment Decisions amongst Medical Practitioners in Sri Lanka." European Journal of Business and Management Research 6, no. 4 (July 15, 2021): 123–26. http://dx.doi.org/10.24018/ejbmr.2021.6.4.952.
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Financial literacy is very essential for any individual in order to efficient and effective decisions regarding their personal investments. Based on that scenario, this study examines the impact of financial literacy on personal investment decisions amongst medical practitioners in Sri Lanka. Personal investment decision has been considered as the dependent variable while financial knowledge, financial skills and financial attitude has been considered as the proxies for the independent variable. Deductive approach has been employed using primary data which is obtained from 205 respondents throughout the country. Descriptive and inferential statistics such as multiple linear regression have been used for the analysis purpose. The results suggested that there is a significant impact between the financial knowledge and financial skills on investment decision while the financial attitude does not have a significant impact on the investment decision. The empirical findings of this study are helpful for any individual who is willing to take effective investment decisions, academics, policy makers and all other related interested parties.
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Rosenberg-Yunger, Zahava R. S., and Ahmed M. Bayoumi. "EVALUATION CRITERIA OF PATIENT AND PUBLIC INVOLVEMENT IN RESOURCE ALLOCATION DECISIONS: A LITERATURE REVIEW AND QUALITATIVE STUDY." International Journal of Technology Assessment in Health Care 33, no. 2 (2017): 270–78. http://dx.doi.org/10.1017/s0266462317000307.
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Objectives: We developed specific evaluation criteria to assess patient and public involvement in resource allocation decisions in health care.Methods: We reviewed the literature from health and other sectors relevant to stakeholder involvement and conducted twenty-seven key informant interviews with stakeholders knowledgeable about patient and public involvement in Canadian drug resource allocation decisions. We used an inductive qualitative thematic approach to analyze the interviews with codes and categories developed directly from individuals’ interview transcripts.Results: Integrating respondents’ comments and the literature review, we identified nine evaluation criteria of patient and the public involvement in healthcare resource allocation decision making: clarity regarding rationale and roles of patient and public members, sufficient support, adequate representation of relevant views, fair decision-making processes, legitimacy of committee processes, adequate opportunity for participation, meaningful degree of participation, noticeable effect on decisions, and considerations of the efficiency of patient and public involvement.Conclusions: Our results will help to develop methods to evaluate patient and public involvement in healthcare decision making.
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Gagnon, Marie-Pierre, Sylvain L'Espérance, Carmen Lindsay, Marc Rhainds, Martin Coulombe, and François Rousseau. "VP163 Patient Involvement In The Development Of Multi-Criteria Decision Tool." International Journal of Technology Assessment in Health Care 33, S1 (2017): 223. http://dx.doi.org/10.1017/s0266462317003993.
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INTRODUCTION:Healthcare organizations should assess the relevance of both existing and new practices. Involving patients in decisions regarding which health technologies and interventions should be prioritized could favor a better fit between strategic choices and patients needs.METHODS:Following a systematic review of existing multi-criteria decision support tools and a consultation with hospital clinicians and managers, a set of potentially relevant criteria was identified. A three-round modified Delphi study was then conducted among four groups (hospital managers, heads of department, clinicians, and patient representatives) in order to reach consensus on criteria that should be considered in the tool.RESULTS:In total, seventy-four participants completed the third round of the Delphi study. Consensus was obtained on twelve criteria. There were some significant differences between groups in priority scores given to criteria. Patient representatives differed significantly from other groups on two criteria. Their ranking of the accessibility criteria was higher, and their ranking of the organizational aspect criteria was lower than for the other groups.CONCLUSIONS:Patient representatives can be involved in the development of a multi-criteria decision support tool to identify, evaluate and prioritize high value-added health technologies and interventions in order to enhancing clinical appropriateness The fact that accessibility aspects were more important for patient representatives calls for specific attention to these criteria when prioritizing health technologies or interventions. Furthermore, we need to ensure that the decisions made regarding the relevance of these technologies and interventions also reflect patients’ preferences.
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Slosky, Laura E., Marilyn Stern, Natasha L. Burke, and Laura A. Siminoff. "Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials." International Journal of Pediatrics 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/676023.
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Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT).Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview.Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment.Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population.
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McCloskey, Bridgeen, Carmel Hughes, and Carole Parsons. "A qualitative exploration of proxy decision makers’ expectations of prescribed medications for people with advanced dementia." Palliative Medicine 32, no. 6 (February 27, 2018): 1114–23. http://dx.doi.org/10.1177/0269216318757163.
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Background: Proxy decision makers often have to make decisions for people with advanced dementia. Their expectations regarding prescribed medications have the potential to influence prescription or withdrawal of medications. However, few studies to date have explored this. Aim: To explore proxy decision makers’ expectations of prescribed medications for people with advanced dementia and to consider how these change with changing goals of care and dementia progression. Design: This is a qualitative semi-structured interview study. Setting/participants: In total, 15 proxy decision makers of people with advanced dementia were recruited via general practitioners ( n = 9), Join Dementia Research ( n = 3) and the Alzheimer’s Society Northern Ireland ( n = 3). Results: Five key themes emerged: the role as advocate, attitudes to medicines and medicine taking, uncertainty over the benefit of anti-dementia medications, stopping medications, and communication and decision-making. Proxy decision makers desired more information about prescribed medicines, particularly the indications, benefits and risks of treatment. Despite uncertainty about the benefits of anti-dementia medications, proxy decision makers were reluctant for these medications to be withdrawn. Reluctance to stop other prescribed medicines was also expressed but reduced with changing goals of care and dementia progression. Although some proxy decision makers expected to be involved in medication-related decisions, the majority preferred to delegate these decisions to healthcare professionals. However, they expected to be informed of any medication-related decisions made. Conclusion: Proxy decision makers vary in terms of their desire for active involvement in the medication decision-making process. Healthcare professionals should facilitate proxy decision maker involvement if desired. Further research is required to consider the impact of proxy decision maker involvement in decision-making.
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Schwarting, Wilko, Javier Alonso-Mora, and Daniela Rus. "Planning and Decision-Making for Autonomous Vehicles." Annual Review of Control, Robotics, and Autonomous Systems 1, no. 1 (May 28, 2018): 187–210. http://dx.doi.org/10.1146/annurev-control-060117-105157.
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In this review, we provide an overview of emerging trends and challenges in the field of intelligent and autonomous, or self-driving, vehicles. Recent advances in the field of perception, planning, and decision-making for autonomous vehicles have led to great improvements in functional capabilities, with several prototypes already driving on our roads and streets. Yet challenges remain regarding guaranteed performance and safety under all driving circumstances. For instance, planning methods that provide safe and system-compliant performance in complex, cluttered environments while modeling the uncertain interaction with other traffic participants are required. Furthermore, new paradigms, such as interactive planning and end-to-end learning, open up questions regarding safety and reliability that need to be addressed. In this survey, we emphasize recent approaches for integrated perception and planning and for behavior-aware planning, many of which rely on machine learning. This raises the question of verification and safety, which we also touch upon. Finally, we discuss the state of the art and remaining challenges for managing fleets of autonomous vehicles.
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Sanches, Cida, and Michele Franco. "Influence of Emotions on Decision-Making." International Journal of Business and Social Research 6, no. 1 (February 22, 2016): 40. http://dx.doi.org/10.18533/ijbsr.v6i1.908.
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<p>The purpose of this study is to verify whether emotions and feelings influence the decisions of entrepreneurs differently in terms of gender using data collected via instruments i.e. questionnaire and a semi-structured interview. The findings suggest that out of 13 factors under study, 8 showed significant differences in the responses given by the two groups: love, unfairness, compassion, dissension, individualism, insecurity, anger and surprise. Men tend to face a decision situation as an intellectual challenge. They avoid listening to other people and decide rapidly, as they understand these actions as a sign of capacity and independence. The results showed that male and female entrepreneurs are significantly affected by feelings and emotions. Women showed a greater tendency than men did towards the following factors: love, jealousy and dissension. This study contributes to the entrepreneurship liteature and broadens the empirical base of studies related to the influence of emotions and feelings of male and female entrepreneurs, providing a possible new perspective regarding decisions, taking into account the gender of the decision maker.</p>
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Sasmito, Hery Abduh. "Ultra Petita Decision of Constitutional Court on Judicial Review (The Perspective of Progressive Law)." Journal of Indonesian Legal Studies 1, no. 1 (August 15, 2017): 47–68. http://dx.doi.org/10.15294/jils.v1i01.16568.
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This research come up from the premise that in the execution of their duties during this time, the Constitutional Court issued many decisions by some legal experts considered break the limits of his authority. One is on a judicial review which contains ultra petita decisions. Regarding to that condition, some parties considered that the Court has acted as an institution that is authoritarian and violated its authority, but on the other hand, the Court instead declared itself as the guardian of democracy and substantive justice. Author argued that, the prohibition to use a doctrine of ultra petita for judge was not generally applicable. Through normative approach and systematic interpretation said that on Law concerning to Constitutional Court (MK, Mahkamah Konstitusi) or other MK decisions did not give any possibilities for Judge to make an ultra petita decision.
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Cowan, Terrence R. "Drugs and the Workplace: To Drug Test or Not to Test?" Public Personnel Management 16, no. 4 (December 1987): 313–22. http://dx.doi.org/10.1177/009102608701600403.
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Many companies and unions are becoming aware of workplace alcohol and other drug problems. They are in the process of identifying their options to determine the best course of action. One of the decisions they will make is whether or not to drug test. The article outlines a straightforward methodology useful for making a decision about drug testing. The approach is based on information provided in response to three questions: What is the extent of workplace drug problems? What strategies are available to deal with the problem and how effective are they? What are some guidelines to consider in a decision regarding drug testing?
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Ross, Diana, Nitya Bakshi, Kirshma Khemani, Cynthia Sinha, George Loewenstein, and Lakshmanan Krishnamurti. "What Are the Expectations of Patients in Decision Making Process for Disease Modifying Therapies for Sickle Cell Disease: Do They Care about Shared Decision Making?" Blood 128, no. 22 (December 2, 2016): 5968. http://dx.doi.org/10.1182/blood.v128.22.5968.5968.
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Abstract Background Medical decisions regarding disease modifying therapy for sickle cell disease (SCD) such as chronic blood transfusion, hydroxyurea, and bone marrow transplantation are complex and have many short and long term implications for the patient's health. Shared decision-making, a collaborative process that allows patients and healthcare providers to make health care decisions collaboratively taking into account the best clinical evidence available as well as the patient's values and preferences, is considered the preferred process in complex medical decisions. There is a paucity of information regarding perspectives of patients with SCD and their caregivers regarding shared decision-making. The objective of this study was to determine the perspective of patients and their caregivers regarding shared decision making in disease modifying therapy for SCD. Methods We conducted qualitative interviews of patients with SCD as well as their caregivers from a geographically diverse population recruited from attendees at regional and national conferences for SCD. A semi-structured open-ended interview guide was used to collect data. Interview guide focussed on determining the expectations of patients and caregivers in their interaction with their physician and their involvement in decision making regarding disease modifying therapy. Interviews lasted 30-60 minutes and were recorded. Audio recordings were transcribed verbatim. Transcripts were coded using qualitative content analysis with NVivo 10. Results Participants were African American, average age was 40 (SD 10.8), 18 of 19 were female, one had a high school degree, eight had some college, and 10 had either a bachelor's or graduate degree.Qualitative analyses yielded the following themes: 1. Patients prefer decision making to occur as a collaborative process between a patient or caregiver and the physician. They indicated that physician and patient each brings their own expertise to the table when discussing treatment. They strongly endorsed that patients should make an informed decision based on ability to comply and personal goals, preferences, and beliefs. 2. Patients prefer that the physician provide information about SCD, including complications and expected long-term outcomes based on the literature as well as personal knowledge of the patient. Patients indicated a desire to receive information in an unbiased fashion. Participants felt that it is the physician's responsibility to provide verbal and written information as well as referral to websites of value in learning. 3. Participants felt that physicians should be aware of their patient's medical history and personal preferences for care. 3. Patients prefer to receive detailed information on side effects and expectations of the impact of treatment on the patient based on the literature and physician experience. 4. Patients would like for the physician to listen to the patient and attempt to understand the patient perspective regarding self-care. 5. Patients have the responsibility to understand SCD and its complications, including expected long-term outcomes of SCD. Participants also underlined the importance of patients making an effort to understand the treatment being offered, including intended purpose, expected outcome, risks, and benefits. Participants felt that patients need time to do their own research and learning before making a decision. 6. Multiple sources for learning about SCD and treatment options. These include education by the physician and asking questions, talking to other patients, doing research on the internet, and personal knowledge of their medical history to including the way their body responded to past treatment. 7. Nurses, and social workers can have a supportive role in decision-making, and can address past medical history and provide guidance regarding socioeconomic barriers to care. 8. Extended family, unless living with the patient, plays a supportive role but is not part of the decision-making team. Conclusion The perspective of patients and their caregivers suggests strong support for shared decision making collaboratively with the physician, supported by high quality information and based on the patient's personal values and preferences. These data provide a rationale for developing and implementing measures to facilitate shared decision making for disease modifying therapy for SCD. Disclosures No relevant conflicts of interest to declare.